title: The self and its resting state in consciousness: an investigation of the vegetative state.
abstract: Recent studies have demonstrated resting-state abnormalities in midline regions in vegetative state/unresponsive wakefulness syndrome and minimally conscious state patients. However, the functional implications of these resting-state abnormalities remain unclear. Recent findings in healthy subjects have revealed a close overlap between the neural substrate of self-referential processing and the resting-state activity in cortical midline regions. As such, we investigated task-related neural activity during active self-referential processing and various measures of resting-state activity in 11 patients with disorders of consciousness (DOC) and 12 healthy control subjects. Overall, the results revealed that DOC patients exhibited task-specific signal changes in anterior and posterior midline regions, including the perigenual anterior cingulate cortex (PACC) and posterior cingulate cortex (PCC). However, the degree of signal change was significantly lower in DOC patients compared with that in healthy subjects. Moreover, reduced signal differentiation in the PACC predicted the degree of consciousness in DOC patients. Importantly, the same midline regions (PACC and PCC) in DOC patients also exhibited severe abnormalities in the measures of resting-state activity, that is functional connectivity and the amplitude of low-frequency fluctuations. Taken together, our results provide the first evidence of neural abnormalities in both the self-referential processing and the resting state in midline regions in DOC patients. This novel finding has important implications for clinical utility and general understanding of the relationship between the self, the resting state, and consciousness.
authors.affiliation: Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada; Zhejiang Key Laboratory for Research in Assessment of Cognitive Impairments, Hangzhou Normal University, Hangzhou, People's Republic of China.
authors.forename: Zirui
authors.initials: Z
authors.lastname: Huang
authors.forename: Rui
authors.initials: R
authors.lastname: Dai
authors.forename: Xuehai
authors.initials: X
authors.lastname: Wu
authors.forename: Zhi
authors.initials: Z
authors.lastname: Yang
authors.forename: Dongqiang
authors.initials: D
authors.lastname: Liu
authors.forename: Jin
authors.initials: J
authors.lastname: Hu
authors.forename: Liang
authors.initials: L
authors.lastname: Gao
authors.forename: Weijun
authors.initials: W
authors.lastname: Tang
authors.forename: Ying
authors.initials: Y
authors.lastname: Mao
authors.forename: Yi
authors.initials: Y
authors.lastname: Jin
authors.forename: Xing
authors.initials: X
authors.lastname: Wu
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Yao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Lu
authors.initials: L
authors.lastname: Lu
authors.forename: Steven
authors.initials: S
authors.lastname: Laureys
authors.forename: Xuchu
authors.initials: X
authors.lastname: Weng
authors.forename: Georg
authors.initials: G
authors.lastname: Northoff
mesh_terms: D000161:Acoustic Stimulation; D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002648:Child; D003243:Consciousness / Q000502:physiology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016014:Linear Models; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D018458:Persistent Vegetative State / Q000473:pathology* / Q000503:physiopathology*; D012146:Rest / Q000502:physiology*; D012649:Self Concept; D055815:Young Adult
chemical_list: D010100:Oxygen
keywords: coma; cortical midline regions; disorders of consciousness; fMRI; functional connectivity; low-frequency fluctuations; minimally conscious state; resting state; self-referential processing; vegetative state